Mindfulness-based stress reduction for people living with HIV/AIDS: preliminary review of intervention trial methodologies and findings

Abstract

In the context of successful antiretroviral therapy (ART) for the management of HIV infection, the harmful effects of stress remain a significant threat. Stress may increase viral replication, suppress immune response, and impede adherence to ART. Stressful living conditions of poverty, facing a chronic life-threatening illness and stigma all exacerbate chronic stress in HIV-affected populations. Stress-reduction interventions are urgently needed for the comprehensive care of people living with HIV. Mindfulness-based stress reduction (MBSR) is one approach that has shown promise as an intervention for patients facing other medical conditions for reducing disease progression, psychological distress and maladaptive behaviours. In this systematic review, we identified 11 studies that have examined MBSR as an intervention for HIV-positive populations. Of the studies, six were randomised designs, one was a quasi-experimental design, and the remaining four were pre- and post-test designs. The preliminary outcomes support MBSR to decrease emotional distress with mixed evidence for impact on disease progression. Effect sizes were generally small to moderate in magnitude. The early findings from this emerging literature must be considered preliminary and support moving forward with more rigorous controlled trials, evaluated with objective assessments in longer-term follow-ups to determine the efficacy of MBSR for people living with HIV.

Social support and posttraumatic growth in a longitudinal study of people living with HIV: the mediating role of positive affect

“…Clinicians and researchers should further investigate the combined role of social support and positive affect in promoting positive change among PLWH. More specifically, complementary and integrative interventions, such as mindfulness, focused on enhancement and sustainment of positive affect among PLWH, should be an adjunct to traditional mental health screening among this patient group, especially that the effectiveness of such interventions for psychological health has been empirically proven (Moskowitz et al, 2017; Riley & Kalichman, 2015; Wilson et al, 2016). …”

Dispositional mindfulness in people with HIV: Associations with psychological and physical health

“…To the extent that these are HIV-specific stressors, it is possible that the associations among mindfulness, stress and coping variables, and well-being differ in people living with HIV compared to people coping with other kinds of stress. There is growing interest in mindfulness-based interventions for people living with HIV (Riley & Kalichman, 2014), but less is known about the potential pathways through which these interventions have an effect. The first step in delineating these pathways is to explore associations of mindfulness with hypothesized mediators in samples of people living with HIV.…”

Expression of gp120 in mice evokes anxiety behavior: Co-occurrence with increased dendritic spines and brain-derived neurotrophic factor in the amygdala

“…Indeed, the suicide rates are three times higher than in the general population (Carrico, 2010). In addition, anxiety-induced stress has also been shown to promote viral replication, reduce immune responses and interfere with antiretroviral therapy [reviewed in (Riley and Kalichman, 2015)]. Individuals with anxiety and psychiatric comorbidities have lower adherence to HIV medications, decreased quality of life, greater health care utilization, and poorer prognosis when compared to individuals without psychiatric disorders (Cohen et al, 2007; Weaver et al, 2005).…”